Volume 4, Issue 1, Spring 2011 Rome Foundation Newsletter
Douglas A. Drossman, MD
President, Rome Foundation
Senior Editor, Rome III Book
It is again a pleasure to send you our Regulatory Agency attended; we are hopeful that this meeting
biannual newsletter an update on the will spur interest in the development of standards for multi-
Rome Foundation’s activities. There has national research, just as the Foundation has provided guidance
been considerable growth and some new for diagnostic criteria and endpoints and outcomes in clinical
initiatives which I am pleased to present. trials. The presentations and supplementary material will soon
be available on our website (www.theromefoundation.org).
In our effort to stay connected to the field, thanks to Michele Of course we continue to hold educational programs at United
Pickard our administrator, we have set up a program for European Gastroenterology Week (UEGW) and at venues in
“Associates of Rome” and to date we have 54 associates from Eastern Europe, Latin American and Asia. Most recently the Asian
22 countries. These individuals, most of whom are in academic Working Team for Functional GI Disorders (Kok Ann Gwee MD,
positions in their countries are afforded closer communication PhD –Singapore, Chair, William E. Whitehead PhD –USA, Co-Chair)
with Rome Foundation activities, discounts on functions and with representatives from 6 Asian countries convened at the
educational products and open access to our newsletters and Asian Neurogastroenteroogy and Motility Association in Beijing
other materials. to begin a multi-national survey of the prevalence of FGIDs in the
clinical setting. This information will be used to help develop or
We continue to grow our association with the American modify existing criteria that will be of value to studies involving
Gastroenterological Association. This includes a co-marketing the Asian community.
arrangement to provide some of our educational products
and a collaboration on several learning initiatives for AGA Our Working Teams remain active and The Role of Intestinal
members. Perhaps one of the more exciting one is to develop Microbiota in Functional GI Disorders (Magnus Simren MD –
a 1½ day communication skills workshop designed to manage Sweden, Chair; Giovanni Barbara PhD – Italy, Co-Chair) is more
difficult clinical scenarios and to enhance the patient-physician than halfway through the process and expect to submit their
relationship in caring for patients with FGIDs. review of the field and recommendations for research later this
year. After a 2 year hiatus to complete additional research, the
We have also expanded our translations of educational materials Severity in IBS (Doug Drossman MD – USA, Chair; Lin Chang MD
into many languages and have begun several global educational - USA Co-Chair) has completed their work and the manuscript is
and research programs. Dr. Ami Sperber (Israel) has taken currently under review. Two new important working teams under
forwarded our efforts to provide international availability for development include one on Food and Diet (William Chey MD –
our questionnaires and criteria and currently there are over 16 USA, and Jan Tack, MD, PhD – Belgium, Co-Chairs) and another
translations completed or underway, and our Rome III book is on Multi-National Cross Cultural Research in the FGIDs (Ami
now published in Chinese, Japanese and Spanish. Our publication Sperber MD – Israel, Chair). The information provided by these
of the Rome Foundation Algorithms for Common GI Symptoms in committees will be well timed for the Rome IV committees to use
the American Journal of Gastroenterology in April, was replicated in their work on building the new chapters.
thanks to the efforts of Dr. Max Schmulson (Mexico) into Spanish
and published in the Mexican Journal of Gastroenterology this Lin Chang, MD (USA) continues to chair our educational activities
past November. and possibly the highlight this year will be the 4th Annual Rome
Foundation – AGA Institute Lecture at DDW. We will have two
With regard to global education, the Rome Foundation sought speakers for this session to be held on Sunday, May 8 from 10:30
collaboration in association with the World Gastroenterology – noon in Room E 451B in the Chicago convention Center. Both
Organisation (WGO) produced a multi-national conference speakers are from Columbia University in NYC, and they will
on cross-cultural research and care in IBS. “IBS – The Global be presenting on the brain and gut aspects of neurogenesis.
Perspective” which was held at the Pfister Hotel in Milwaukee, Tarique Perera MD will speak on “The Role of Neurogenesis in
WI on April 6-7 just prior to the IFFGD International Conference the Brain” and Michael D. Gershon MD will discuss “The Role of
on Functional GI disorders. This conference provided the venue Neurogenesis in the Enteric Nervous System” as related to the
for understanding IBS from a multinational and multi-cultural Functional GI Disorders.
perspective. This information will continue to be of interest to
academicians, clinicians, industry representatives and regulatory Our research program under the direction of Bill Whitehead,
agencies. Representatives from the FDA, EMEA and the Japan PhD (USA), has finalized the selection of our Rome Foundation
continued on page 2
www . theromefoundation . org
Program and Project uPdates
continued from page 1
Research Award and our Ray Clouse Prize for the Best Research
in the FGIDs along with a new award, the Ray Clouse Award Planning for Rome IV
for Paper Most Cited in Functional GI and Motility Disorders.
The awards will be presented at our annual reception at DDW
on Saturday evening at 6 PM in Chicago. The Rome Foundation is beginning to plan for Rome IV.
This will be an update of knowledge of the functional
The most exciting news to report is that the Rome IV process GI disorders with the inclusion of new diagnostic
criteria. There are several new features that are worth
has just begun. An editorial board will be in place by DDW in noting. First, careful attention is being paid to produce
May and there will be several new and exciting initiatives that the most needed information for this publication. A
will help carry the field of FGIDs forward. planning committee will select the Editorial board
• Publication will be delayed to 2015-2016. This will and make recommendations for the publication
permit the use of support committees that will be content. The editorial board will have an active role
charged to provide new information that will help the in selecting the committee chairs, coordinating the
publication, and each board member will serve as
Rome IV committees in their work. The committees a liaison with one or two chapter committees to be
will include those doing systematic reviews and meta- sure there is consistency in the work effort across
analyses, working on cross-cultural aspects of the chapters. Standards for selecting chapter committee
FGIDs, and looking at the application of the information members will based on academic credibility will be
in primary care and others. maintained.
• We plan to focus more on online access to the Another new feature will be a delay in the publication
information by computer or iPad. For a subscription, date. While in the past the publication sequence from
individuals will be able to free text search for Rome I, to II to III had been 6 years, it is expected that
information or download chapters or the entire the Rome IV will be published late 2015 or early 2016,
book. Of course hard copies of the book and a journal about 10 years after the Rome III book in 2006. The
supplement containing abridged information will be main reason is to allow enough time for new data to
available as usual. accumulate that will be used by the Rome IV chapter
committees. In addition there will be several “support
• In keeping with our efforts to disseminate information committees” activated to facilitate the provision of
globally we will work to provide simultaneous new knowledge that will be made available for the
translation of the chapter material at the time of or chapter committees to use in their work. This will
soon after publication of Rome IV include many of the existing and newly developed
working teams on severity, intestinal microflora, cross-
• The content will be expanded to include more cultural aspects (Asian working team) and food and
information on Women’s Health, biomarkers and nutrition. In addition we expect to set up a committee
global aspects of research and patient care of experts to do meta-analyses for the committees, as
• We also plan to develop products derived from this well as a committee to make recommendations for
content that is more portable. This will include pocket multi-national research. As a result the chapters to
come out for Rome IV will have new information to
information on the criteria, a primary care version and help in their recommendations.
products for use by our sponsors.
• Finally, we recognize that the diagnostic criteria while We are also looking to improve the distribution of
helpful for recruitment into research studies, do not this new knowledge. Rome IV will be accessible
electronically by text searching or downloading of
fully capture the spectrum of the patient within the sections, chapters or the entire book, in addition to
clinical context. Accordingly we plan to develop a multi- hard copy availability. We plan to have simultaneous
dimensional clinical profile classification in addition translation of the book into several languages at
to the diagnostic criteria, which will encompass the time of publication or soon thereafter. Ceciel
aspects of severity and disability, level of physiological Rooker, managing editor and public relations director
dysfunction and psychosocial co-morbidity. will be working with the committees to produce
“deliverables” that can be distributed by sponsors
Our mission: “To improve the lives of people with functional to clinicians. This may include smaller brochures or
information cards for example of the criteria that
GI disorders” and our three goals, to: “promote clinical can fit in a lab coat. Finally, we plan to have multiple
recognition and legitimization of the functional GI disorders”, “launches” at major GI meetings in the US and with
“develop a scientific understanding of their pathophysiological the help of our International Liaison Committee at
mechanisms” and “optimize clinical management for patients major international conferences.
with FGIDs” continue to drive all activities. We are grateful for
our 14 industry sponsors and look forward to working with you
to advance the field of FGIDs. We are hopeful that Rome IV will be a welcome
addition to investigators, clinicians, regulatory
agencies and our industry sponsors. Stay tuned.
Douglas A. Drossman, MD
2 r ome foundation
r ome f ounDaTion B oarD of D irecTors
Douglas A. Drossman, MD
Chapel Hill, NC USA
Fernando Azpiroz, MD, PhD Robin Spiller, MD, MSC
Barcelona, Spain Nottingham, England
Lin Chang, MD Jan Tack, MD, PhD
Los Angeles, CA USA Leuven, Belgium
William D. Chey, MD Nicholas J. Talley, MD, PhD
Ann Arbor, MI, USA Newcastle, NSW, Australia
John Kellow, MD, FRACP William E. Whitehead, PhD
New South Wales, Australia Chapel Hill, NC, USA
O ur missiOn is :
“T o i m prove T he lives of p eo pl e w i Th f u n cTi o n a l Gi D i s o rDer s .”
rome founDaTion aDminisTraTion
Executive Director Administrator Medical Illustrator
William N. Hilliard, Jr. Michele Pickard Jerry Schoendorf
Raleigh, NC, USA Chapel Hill, NC, USA Chapel Hill, NC, USA
Public Relations Sarah Barrett Website/Newsletter Design
Ceciel Rooker Administrative Assistant for Ceara Owre
Chapel Hill, NC, USA Public Relations Chapel Hill, NC, USA
Chapel Hill, NC, USA
t able of c ontents
Program and Project UPdates meeting and events
Presidents rePort 1 meet the exPerts at uegw 2011 12
education rePort 4 iBs - the gloBal PersPective 13
welcome new executive director 4 rome foundation/aga lectureshiP
rome translation Project 5 at ddw 2011 14
rome foundation research Program 6
rome foundation working team 10 annoUncements
associates of rome 11 iffgd uPdate 15
rome foundation legal counsel 17
rome and aga collaBoration 18
rome criteria reference list 19
www . theromefoundation . org 3
Program and Project uPdates
Rome Foundation Educational Program
Lin Chang, MD
Chair, Education Committee
There are both continuing and new educational programs that of Neurogenesis in the Brain and Gut and its Implications for
the Rome Foundation has been working on. These include the Functional GI and Motility Disorders. Dr. Perera is an Assistant
Rome educational slide sets on FGIDs, the annual Rome-AGA Professor in Clinical Psychiatry will discuss the suppression of
lectureship at Digestive Diseases Week (DDW), and a Best of neurogenesis in the brain, specifically the hippocampus, and
DDW FGID abstract webcast. its role in increasing the vulnerability to developing depression.
Dr. Perera’s work has important implications for functional
Rome educational slide sets gastrointestinal disorders (FGIDs) because of their overlap with
The Computer-Based Learning Program includes state-of-the-art depression and that antidepressants, which restore and stimulate
slides that brings to life information from the Rome III book on neurogenesis, are frequently used to treat FGIDs. Dr. Gershon is an
FGIDs. This educational program is endorsed by AGA Institute. internationally renowed scientist who has studied microcircuits
The slide set includes a wide range of information that spans within the enteric nervous system and their regulation of motor,
from epidemiology to pathophysiology to treatment. A number secretory and absorptive functions within the GI tract and their
of animations, videos and conceptual slides help to communicate relevance in functional and motility GI disorders. The Rome-AGA
ideas that may otherwise seem difficult to convey. Notes and lectureship will take place on Sunday, May 8, 2011 at 10:30am.
legends for every slide give a description of the slide with key
references. Best of DDW webcast
Rome Foundation Board members will review and discuss the
Fourth Annual Rome-AGA lectureship at the DDW best abstracts on FGIDs from this year’s DDW. Working with
Two faculty members from Columbia University, Dr. Tarique the GI Health Foundation on this educational endeavor, this
Perera and Dr. Michael Gershon, will lecture at the Fourth Annual information will be broadcast on a webcast that will be available
Rome-AGA lectureship at this year’s DDW meeting on The Role for viewing soon after the meeting.
Welcome William (“Wink”) Hilliard Jr.
Executive Director Rome Foundation
We are grateful to Mr. George Degnon and Ms. Kathy Haynes of including the NC Society of Anesthesiologists, the NC Society of
Degnon and Associates for their 15 years of service and support Internal Medicine, and the NC College of Emergency Physicians.
to the Rome Foundation. As of January 1, the business operations He has extensive experience in meeting management and the
have moved from Degnon Associates to Hilliard Associates in provision of financial services including portfolio management.
Raleigh, NC. Mr. William (“Wink”) Hilliard Jr. will then continue as Mr. Hilliard will represent the Foundation in its many activities,
Executive Director of the Rome Foundation and will handle all the coordinate sponsor related contracts, financial reports, fund
day to day activities. Mr. Hilliard is a graduate of the University raising and distribution of our books and educational products.
of North Carolina in Chapel Hill and held an academic position He can be reached at P.O. Box 6524, Raleigh, NC 27628.
in Corporate and Divisional Strategic Planning. His experience Phone: 919-787-5859, Fax: 919-900-7646, email: whilliard@
has involved the management of several medical organizations theromefoundation.org.
4 r ome foundation
Program and Project uPdates
Rome Translation Project - Update
Ami D. Sperber, MD, MSPH
Chair, Rome Foundation
The increasing interest in research in IBS and other functional The challenge of cross-cultural translation is to adapt an
gastrointestinal disorders (FGIDs) and the growing sophistication instrument so that it retains the meaning and intent of the
of communication technology make cross-cultural, multinational original instrument (the source language) and is culturally
research a feasible endeavor. Collaborative multinational, cross- relevant and comprehensible in the target language. Thus, the
cultural studies in FGIDs, using appropriate research methodology, aim is to achieve a "cultural" rather than a "literal" translation
can make a significant contribution to the understanding of FGIDs into a target language.
and to patient care.
The project has developed official guidelines for translation of
In addition, pharmaceutical companies are increasingly conduct- these materials that must be followed before Rome Foundation
ing trials of new drugs in numerous countries around the world. approval is granted. The guidelines are available for download at
The conduct of multinational research successfully requires an the Rome Translations Project website: www.theromefoundation.
infrastructure of study instruments validly translated into the org/translations/guidelines.cfm. More complete information on
languages of the study populations. the translation project can be found at its homepage at: www.
theromefoundation.org/translations/. The project will both
"The Rome Translation Project", headed by Dr. Ami Sperber, monitor translation initiated by others and initiate translations
was established to oversee the translation of all relevant Rome itself. Approval is required for all uses of translated versions of
Foundation material, in particular the Rome III book, the Rome III the Rome material including research and education.
diagnostic questionnaire, and the Rome clinical algorithms. The
diagnostic questionnaire and criteria, in its approved language Approved language versions of the Rome questionnaires will be
versions, will be available for use in epidemiologic studies and available free of charge for academicians conducting independent
clinical trials. studies that are not funded by pharmaceutical companies or
other commercial interests. A
All Adult Adult FD module Adult IBS module Psychosocial alarm request can be placed through
Language Pediatric Alarm questions
Modules * Stand-alone Stand-alone questionnaire
the translation project website.
Arabic To be started
In commercially funded studies
a fee will be charged for the use
Included in “All Included in “All
Yes Yes Yes
of translated questionnaires.
Adult Module” Adult Module” In all events a licensing
Dutch No No Yes Yes
agreement will be signed
with the Rome Foundation
French In progress In progress In progress
before the translated version
is provided to the investigator.
German Yes Yes Yes In progress
Dr. John Kellow will be in
charge of licensing and fee
Included in “All Included in “All
Adult Module” Adult Module”
Included in “All Included in “All The following table details
Italian Yes Yes
Adult Module” Adult Module” available language versions
Included in “All Included in “All as of the moment. This is an
Japanese Yes Yes Yes Yes
Adult Module” Adult Module” ongoing project with an ever-
Included in “All Included in “All increasing number of available,
Adult Module” Adult Module” validated translations.
Malay-Bahasa No Yes Yes Yes Yes
Norwegian No In progress Yes
Portuguese Yes To be started
Included in “All Included in “All *All adult modules includes
Adult Module” Adult Module”
Yes Yes Yes Functional Dyspepsia (FD)
module, IBS module, Alarm
Thai No In progress questions, and psychosocial
www . theromefoundation . org 5
Program and Project uPdates
Rome Foundation Research Program
William E. Whitehead, PhD
Chair, Research Committee
Rome Foundation Research Award
The Rome Foundation provides a $50,000 research grant each year to a young investigator. Preference is given to
applications that (1) test the validity and/or utility of the Rome III diagnostic criteria, (2) assess the epidemiology of
functional GI and motility disorders, or (3) advance knowledge of outcome assessment or trial design for FGID treatment
trials. The applications receive an NIH-style review by an independent review committee. This year the review committee
was chaired by Dr. Brooks Cash, Professor of Medicine at the Uniformed Services University for the Health Sciences and
Chief of Medicine at Walter Reed Army Medical Center.
Ray Clouse Prize for the Best Research Article on Functional Gastrointestinal
and Motility Disorders 2010
In 2008 the Rome Foundation created an award in memory of Ray E. Clouse, MD, a gastroenterologist and scholar at
Washington University School of Medicine and a devoted member of the Rome Foundation. This award recognizes the
author of the best original research paper published in the functional gastrointestinal and motility disorders for the
calendar year preceding each DDW. While many papers are nominated by the Board of the Rome Foundation, anyone may
submit a nomination by briefly describing how the paper will impact the field of functional gastroenterology and motility
along with a pdf of the paper. Rome Foundation board members are ineligible. The best paper is selected by a vote of the
Rome Foundation board.
Ray Clouse Prize for the Most Cited Article in Functional Gastrointestinal and
Motility Disorders 2009
This year a new prize has been created to provide an award for the most cited original research article in functional GI and
motility disorders for the year 2009. Papers by members of the Board of the Rome Foundation are not eligible. The two-year
lag between the year of publication and the year the award is made reflects the fact that citations of a paper are usually
delayed by approximately one year; by choosing a two year lag, the Rome Foundation sought to avoid disadvantaging
papers published late in the calendar year. The most cited paper is identified by the Web of Science search engine.
6 r ome foundation
Program and Project uPdates
Rome Foundation Research Grant Award
2011 WINNER – Lars Agréus MD, PhD
Lars Agréus MD, PhD
Professor and Chair
Center for Family and Community Medicine
Department of Neurobiology, Care Sciences and Society
Karolinska Institutet/Stockholm County Council
Lars Agréus has been a professor of family medicine since and supplementary questionnaires in a random sample of
2007. The focus of his research is gastroenterology in primary 1001 adults. The Kalixanda Study has resulted in three PhD
care. Since September 2009, he has been head of the Center dissertations and 19 scientific publications so far; follow-up
for Family and Community Medicine at Karolinska Institutet, is still underway. Professor Agréus and his research group
Stockholm, Sweden. have also completed a colonoscopy study that included 746
Professor Agréus began his research career in 1987 at randomly selected adult volunteers. The first articles about
the Department of Family Medicine, Uppsala University, this study are in the pipeline for publication.
Sweden. In 1993, he defended his doctoral dissertation, “The Professor Agréus has published approximately 60 scientific
Abdominal Symptom Study.” He spent a postdoctoral year at articles, reviews, and editorials in peer-reviewed journals and
the University of Sydney in Australia studying associations has contributed abstracts to or given lectures at numerous
between the quality of doctors’ consultations and the scientific meetings in the field of gastroenterology. He has
outcome of dyspepsia. Subsequently, he served as a senior been on the board of the European Society for Primary
lecturer in family medicine at Uppsala University. In 2000, he Care since its establishment in 1996 and now serves as the
accepted a position as a senior lecturer and researcher at the society’s president. Professor Agréus is a member of the
Center for Family and Community Medicine in Stockholm. Swedish Gastrointestinal Society and the Swedish Primary
For the past decade, Professor Agréus has focused on Care Society, and is a fellow of the American Gastrointestinal
population-based endoscopy studies. During this time, he Association.
has developed an international network of collaborators Lars Agréus is also a dedicated rural general practitioner.
from the fields of gastroenterology, pathology, microbiology, He has served the same rural district since 1981, and is a
genetics, and psychoneuroimmunology. An example of member of both national and international rural medicine
their work is the Kalixanda Study, an upper endoscopy societies.
study that included endoscopies with biopsies, blood tests,
Functional dyspepsia and functional heartburn: Natural history of symptoms in the general
population and validity of Rome III upper gastrointestinal diagnostic criteria
Background: Functional gastrointestinal disorders Methods: The study builds on a series of postal
(FGIDs) are common and usually life-long conditions surveys of abdominal/gastrointestinal symptoms in
that affect quality of life. Symptoms may fluctuate the same adult random population sample (n ≅ 1400)
over time. However, only a minority of people with in the municipality of Östhammar, Sweden, conducted
symptoms seek health care. A better understanding in 1988, 1989, 1995, and (in a subsample) in 1996,
of the long-term natural history of FGIDs requires using the validated Abdominal Symptom Questionnaire
population-based studies with years or even decades (ASQ). Residents of the municipality ≥ 20 years and born
of follow-up. Moreover, Rome III definitions of upper on the 3rd, 12th, or 24th of each month plus surviving
FGIDs have become the diagnostic standard but have members of the original study population who have
never been validated by esophagogastroduodenoscopy moved elsewhere in Sweden will be mailed a further
(EGD) in non-patients. ASQ in spring 2011. Responders to the spring survey
aged 20 to 80 years will be invited to endoscopy with
Aims: First, to study the natural history of FGIDs, biopsies in fall 2011. At the EGD visit, participants (n ≅
especially functional heartburn (FH) and functional 800) will provide medical history; respond to the Rome
dyspepsia (FD) over 23 years. Second, to validate III questionnaire, the ASQ, and other questionnaires;
the Rome III criteria for upper FGIDs using EGD with and provide a blood sample for biomarker analysis.
biopsies to rule out organic causes. To achieve these Non-response studies will be performed for each study
aims, we will use true population-based data with a step.
high participation rate and robust non-response data
not biased by healthcare-seeking behavior.
www . theromefoundation . org 7
Program and Project uPdates
T he Rome Foundation established an award in memory of Ray
E. Clouse, MD a gastroenterologist and scholar at Washington
University School of Medicine and a devoted member of the
Rome Foundation. Ray’s academic career spanned 27 years of
research, teachings and writings that has left an indelible mark in the
field of functional GI and motility disorders and of gastroenterology
This year, the Rome Foundation is pleased to offer three awards, two
for The Ray Clouse Prize for the Best Research Article on Functional
GI and Motility Disorders, 2010, and a third, new award entitled
The Ray Clouse Prize for the Most Cited Article on Functional GI and
Motility Disorders 2009. The Best Research Article prizes are being
awarded to Tamira K. Klooker MD for her paper, “The mast cell
stabilizer ketotifen decreases visceral hypersensitivity and improves
intestinal symptoms in patients with irritable bowel syndrome”
Ray E. Clouse, MD and to QiQi Zhou MD, PhD for her paper, “MicroRNA-29a regulates
intestinal membrane permeability in patients with irritable bowel
syndrome.” The Most Cited Article prize is being awarded to Siobhain
M. O’Mahony, PhD for her paper, “Early life stress alters behavior,
immunity, and microbiota in rats: implications for irritable bowel
syndrome and psychiatric illnesses.”
Ray Clouse Prize for the Most Cited Article in
Functional Gastrointestinal and Motility Disorders, 2009
Siobhain M. O’Mahony, PhD (award recipient)
with coauthors: Marchesi JR, Codling C, Ceolho AM, Quigley EM, Cryan JF, Dinan TG
Early life stress alters behavior, immunity, and microbiota in rats: implications for
irritable bowel syndrome and psychiatric illnesses. Biol Psychiatry 2009;65:263-7.
BACKGROUND: Adverse early life events are associated with RESULTS: The early life stress increased the number of fecal boli in
a maladaptive stress response system and might increase the response to a novel stress. Plasma corticosterone was increased
vulnerability to disease in later life. Several disorders have in the maternally separated animals. An increase in the systemic
been associated with early life stress, ranging from depression immune response was noted in the stressed animals after an in
to irritable bowel syndrome. This makes the identification of vitro lipopolysaccharide challenge. Increased visceral sensation
the neurobiological substrates that are affected by adverse was seen in the stressed group. There was an alteration of the
experiences in early life invaluable. fecal microbiota when compared with the control group.
METHODS: The purpose of this study was to assess the effect of CONCLUSIONS: These results show that this form of early life
early life stress on the brain-gut axis. Male rat pups were stressed stress results in an altered brain-gut axis and is therefore an
by separating them from their mothers for 3 hours daily between important model for investigating potential mechanistic insights
postnatal days 2-12. The control group was left undisturbed with into stress-related disorders including depression and IBS.
their mothers. Behavior, immune response, stress sensitivity,
visceral sensation, and fecal microbiota were analyzed.
8 r ome foundation
Program and Project uPdates
Ray Clouse Prize for the Best Research Article on
Functional Gastrointestinal and Motility Disorders, 2010
This year two outstanding papers were chosen for this award
Tamira K Klooker, MD (award recipient)
with coauthors: Braak B, Koopman KE, Welting O, Wouters MM, van der Heide S,
Schemann M, Bischoff SC, van den Wijngaard RM, Boeckstaens GE.
The mast cell stabilizer ketotifen decreases visceral hypersensitivity and improves
intestinal symptoms in patients with irritable bowel syndrome. Gut 2010;59:1213-21.
BACKGROUND: Mast cell activation is thought to be involved in RESULTS: Ketotifen but not placebo increased the threshold for
visceral hypersensitivity, one of the main characteristics of the discomfort in patients with IBS with visceral hypersensitivity. This
irritable bowel syndrome (IBS). A study was therefore undertaken effect was not observed in normosensitive patients with IBS.
to investigate the effect of the mast cell stabiliser ketotifen on Ketotifen significantly decreased abdominal pain and other IBS
rectal sensitivity and symptoms in patients with IBS. symptoms and improved quality of life. The number of mast cells
METHODS: 60 patients with IBS underwent a barostat study to in rectal biopsies and spontaneous release of tryptase were lower
assess rectal sensitivity before and after 8 weeks of treatment. in patients with IBS than in healthy volunteers. Spontaneous
After the initial barostat, patients were randomised to receive release of histamine was mostly undetectable but was slightly
ketotifen or placebo. IBS symptoms and health-related quality increased in patients with IBS compared with healthy volunteers.
of life were scored. In addition, mast cells were quantified and Histamine and tryptase release were not altered by ketotifen.
spontaneous release of tryptase and histamine was determined
CONCLUSIONS: This study shows that ketotifen increases the
in rectal biopsies and compared with biopsies from 22 age- and
threshold for discomfort in patients with IBS with visceral
gender-matched healthy volunteers.
hypersensitivity, reduces IBS symptoms and improves health-
related quality of life. Whether this effect is secondary to the
mast cell stabilising properties of ketotifen or H(1) receptor
antagonism remains to be further investigated. Trial Registration
Number NTR39, ISRCTN22504486.
QiQi Zhou, MD, PhD (award recipient)
with coauthors: Souba WW, Croce CM, Verne GN
MicroRNA-29a regulates intestinal membrane permeability in patients with irritable
bowel syndrome. Gut 2010;59:775-84.
BACKGROUND: The molecular mechanisms underlying the RESULTS: A subset of patients with IBS (8/19, 42%) had increased
pathophysiology of irritable bowel syndrome (IBS) are poorly intestinal membrane permeability and decreased glutamine
understood. One mechanism may involve increased intestinal synthetase expression compared to patients with IBS normal
permeability that is reversed with glutamine supplementation. membrane permeability, and to controls. Expression of miR-29a
Our goal was to evaluate the expression of glutamine synthetase was increased in blood microvesicles, small bowel and colon tissues
and its complementary miRNA in blood microvesicles and gut of IBS patients with increased intestinal membrane permeability.
tissues of IBS patients with increased intestinal membrane Increased intestinal permeability was modulated by miR-29a which
permeability. has a complementary site in the 3'-UTR of the GLUL gene.
METHODS: We evaluated 19 diarrhoea-predominant IBS patients CONCLUSIONS: The results support the conclusion that GLUL
and 10 controls for intestinal membrane permeability using the regulates intestinal membrane permeability and miR-29a regulates
lactulose/mannitol method. miRNA expression was evaluated both GLUL and intestinal membrane permeability. The data suggests
in blood microvesicles and gut tissue. To further confirm that miR-29a effects on intestinal membrane permeability may be
the relationship between miRNA and glutamine synthetase due to its regulation of GLUL. Targeting this signalling pathway could
expression, cell culture experiments were conducted. Glutamine lead to a new therapeutic approach to the treatment of patients
synthetase was also evaluated in the gut tissues of patients. with IBS, especially because small molecules that mimic or inhibit
miRNA-based mechanisms are readily available.
www . theromefoundation . org 9
Program and Project uPdates
Rome Foundation Working team committee
The role of the intestinal microbiota in
functional gastrointestinal disorders – March 2011
Magnus Simrén, MD, PhD
The group was formed during the spring 2010 and had a start-up telephone
conference in May 2010, where the aims of the working team were m embers Of the W Orking t eam
clarified and an outline for the publications was discussed. This outline
was thereafter modified and finalized via e-mails in June 2010. The group
members volunteered for the different tasks and a number of groups within C hair
the working team were formed based on the expertise of the members.
Magnus Simrén, MD, PhD
The work was divided between the members and a timeline was decided Gothenburg, Sweden
(updated timeline, see below). Part of the members met at a face-to-face
meeting in Boston at the International Neurogastroenterology and Motility C O -C hair
meeting in August 2010, and those who were not able attend participated
Giovanni Barbara, MD
via telephone. During the autumn/winter 2010/2011, the different chapters Bologna, Italy
for the manuscript, as outlined below, have been prepared, and a first draft
manuscript is currently being prepared. This will be discussed and finalized
at a face-to-face meeting of the Working Team Group the day after Digestive C liniCal
Disease Week in Chicago. Thereafter, an internal review process within the
team, as well as within the Rome Foundation, will be performed and the Peter Whorwell, PhD
goal is to have a manuscript to submit to a major gastroenterology journal
early autumn 2011. Moreover, during this years UEGW in Stockholm, two Brennan Spiegel, MD
lectures, based on the work of this Working Team Group will be given at Los Angeles, CA, USA
a two-days symposium within the congress, entitled “Today’s science;
Robin Spiller, MD
tomorrow’s medicine: Role of bacteria in health and disease”. Nottingham, UK
▪ To critically review the existing literature on t ranslatiOnal
the role of gut microbiota in functional GI Stephen Vanner, MD
disorders (FGIDs), with focus on clinical and Kingston, Canada
translational aspects. Elena Verdu, MD, PhD
▪ Based on the literature search, provide Hamilton, Canada
recommendations how to implement the
current knowledge into clinical practice, in b asiC /m iCrObiOlOgy
order to improve the health of our patients. Erwin Zoetendal, MD
▪ Give recommendations for future work in Wageningen, the Netherlands
order to improve the current knowledge on Harry Flint, PhD
the role of gut microbiota in functional GI Aberdeen, UK
▪ Produce an extensive background document
including all the relevant references and
information of relevance, as well as a
clinically useful, review, submitted to one of
the major scientific journals in our field.
10 r ome foundation
Program and Project uPdates
A s s o c i at e s of R ome
M embership in the Associates of Rome program has more than doubled since the last
newsletter! There are now 54 Associates including gastroenterologists, pediatricians,
primary care physicians, and psychotherapists. Joining is easy (and free), just visit www.
theromefoundation.org/join_mailing/assoc_rome.cfm. Benefits include a discount on Rome
products and conferences, the bi-annual printed newsletter and quarterly e-newsletter,
Rome pin, and a Certificate of Association. Several Associates were recently able to register
at a discounted rate for the IBS – A Global Perspective Conference, held in Milwaukee,
The program best serves health care professionals and investigators. Patients are welcome to
join, but may also want to consider contacting IFFGD (International Foundation for Functional
Gastrointestinal Disorders, www.iffgd.org) for more patient-centered information about life
with GI disorders.
Welcome Associates of Rome
Shahab Abid, PhD Lillian Ethapemi Mildret Quisbert
Pakistan England Bolivia
Peyman Adibi, MD Basem E. Eysa, MD Shaman Rajindrajith, MD
Iran Egypt Sri Lanka
Hamid Afshar, MD Carla Flik, MD Yishai Ron, MD
Iran Netherlands Israel
Marc Beer-Gabel, MD Mojgan Forootan, MD Bengt Safsten, MD, PhD
Israel Iran Sweden
Sheila Bell Jan Gambino, M.Ed Allison Siebecker, MD
Scotland USA USA
Ben Bradenham, MD Ali Gholamrezaei, MD Marconde Silva
USA Iran Brazil
Ragnar Breckan, MD Mary Gross Erin Slater
Norway USA USA
Mohammed Butt Shengxi Han, MD Rosa Soares, MD
Qatar China Brazil
Dan Carter, MD William Hays, MD Christian Speer, MD
Israel USA USA
Jihong Chen, MD, PhD Michio Hongo, MD Ami Sperber, MD
China Japan Israel
Hamed Daghaghzadeh, MD Sandeep Jillella, MD Byron Theron, MD
Iran India UK
Nasser Daryani, PhD Ho Xuan Linh, MD Elisa Tiomny, MD
Iran Viet Nam Israel
Esther Dekel Snezana Lukic, MD Serkan Torun, MD
Israel Serbia Turkey
Roy Dekel, MD Joseph Lysy, MD Minh Minh Tran, MD
Israel Israel Viet Nam
Niranga Devanarayana, MD Alejandro Martinez Emily Tucker, MD
Sri Lanka Mexico UK
Thomas DuHamel, PhD Sabrina Nery, MD Wei Wei, PhD
USA Brazil China
Collin Ellis, PhD Hong Ouyang, MD, PhD John Wyman, MD
USA China USA
Gulin Erdemir, MD Tatjana Puc Kous, MD Lee Yeong Yeh, MD
Turkey Slovenia Malaysia
www . theromefoundation . org 11
meetings and events
Meet the experts
How I manage a patient with a di cult
with Javier Santos
with Magnus Simrén
with André Smout
Chairmen: Robin Spiller
12 r ome foundation
meetings and events
IBS – The Global Perspective conference
April 6-7, 2011
T he Rome Foundation and the World Gastroenterology
Association convened an international symposium on
“IBS – The Global Perspective” that took place on April 6-7,
workshops, one on cross-cultural clinical competence and
the second on cross-cultural research competence. In the
first, the participants witnessed and participated in role-play
2011 in Milwaukee, Wisconsin. simulating real-life cross-cultural clinical situations.
The primary aim of the symposium was to bring together an The conference also had a session with regulatory agency
international group of clinicians, scientists and researchers representatives from the United States (FDA), Europe
with an interest in IBS and other functional GI disorders to (EMEA) and Japan. This session focused on the conduct of
foster greater awareness of the multi-national, cross-cultural multinational clinical trials including developing culturally
aspects of IBS, and update existing knowledge on similarities appropriate study instruments and patient-reported
and differences at a global level. In terms of clinical practice outcomes (PROs).
the focus was on greater awareness of the complexity of
working in a multicultural clinic, and the development clinical The participants in this meeting expressed their feeling
skills to function successfully in that milieu. This included that it was unique and stimulating with an excellent faculty.
awareness of patient and physician explanatory models of There was a feeling that it could energize the functional GI
illness and their cultural associations. In terms of research community to develop new initiatives on an international
the focus was on improving the quality of multinational scale.
clinical trials and research, and establish international
research networks. As one outcome of this meeting the Rome Foundation
has established a working team on multinational, cross-
The participants heard talks from a spectrum of speakers cultural research with a mandate to develop guidelines for
that included gastroenterologists from around the world, future research projects, to foster international research
and medical anthropologists and psychiatrists who provided networks, and to plan and implement a global study on IBS
insights from perspectives that are not usually represented epidemiology.
in meetings of gastroenterologists. There were two
Special thanks to our conference sponsors
Ironwood Pharmaceuticals, Inc.
Procter & Gamble, Co.
Takeda Pharmaceuticals North America, Inc.
Zeria Pharmaceuticals Co., Ltd.
www . theromefoundation . org 13
meetings and events
The Fourth Annual Rome Foundation — AGA Institute
Lectureship at Digestive Disease Week 2011
Sunday May 8, 2011
10:30 - 12:00
E 451B Lakeside Level 4
Mc Cormick Place, Chicago, IL Agenda
The Role of Neurogenesis in
The Rome Foundation and the American the Brain
Gastroenterological Association (AGA) were
pleased to announce their 4th annual lectureship with Tarique Perera, MD
at Digestive Diseases Week (DDW). The Columbia University
lectureship is designed to address broad aspects
of health care that are relevant to digestive
diseases and the functional GI disorders.
1. To discuss the suppression of The Role of Neurognesis in the
neurogenesis in the hippocampus Enteric Nervous System and its
in depression and the potential implications for Functional GI
restoration with antidepressants and Motility disorders
2. To review neurogenesis of enteric with Michael D. Gershon, MD
nerves and their role in gut Columbia University
3. To explain the relevance of
neurogenesis in the central
and enteric nervous systems to
functional GI and motility disorders
Digestive Disease Week
The Rome Foundation encourages all members
and sponsors to visit our booth at DDW. This year
we are proud to offer the Diagnostic Algorithms
for Common Gastrointestinal Symptoms on
CD-ROM. We will also be offering copies of
the Rome III book, published in 2006, as well
as the Computer-Based Learning Program and
Understanding the Irritable Gut, by W. Grant
May 7-10, 2011 Thompson, MD. New this year will be details
about our latest program – Associates of
McCormick Place Rome. A listing of benefits of this initiative and
Chicago, IL enrollment forms will be available at our booth.
There will also be many handouts and other
research materials available. Be sure to visit us
at booth 2354!!
14 r ome foundation
An Update from the International Foundation for
Functional Gastrointestinal Disorders (IFFGD)
2011 marks IFFGD’s 20th year of service to the functional To further advance our legislative priorities, IFFGD will be
gastrointestinal and motility disorders (FGIMDs) community. hosting its Capitol Hill Advocacy Day at the Phoenix Park Hotel
Over the past two decades, much progress has been made in Washington, DC on Tuesday, June 14th and Wednesday,
through efforts to advocate, raise awareness, and advance June 15th, 2011. This event is open to patients, physicians, and
research into FGIMDs. We are humbled and sincerely grateful anyone who wants to make a difference; it is also free of charge
to all who have participated in these efforts. so please contact us and make your plans to attend today.
To honor the dedication of our volunteers and apply their Research & Awareness
contributions to maximum effect, IFFGD has launched a bold Through the Digestive Health Alliance many individuals have
new initiative known as the Digestive Health Alliance™ or already begun conducting volunteer-led fundraisers, such as
DHA. This grassroots network will provide affected individuals walk-a-thons and letter writing campaigns to bolster the IFFGD’s
in towns and cities across America with the tools they need to research fund and raise awareness of FGIMDs. The Foundation
take action in support of the field. In this regard, DHA activities will also be expanding our efforts in these areas by hosting a
will focus on advocating on Capitol Hill, raising awareness, and benefit regatta at the Kenosha Yacht Club in Kenosha, WI on
donating or fundraising for research. August 20th, 2011. In addition to the boat races, this event will
feature a beach party cook-out with live entertainment and
Advocacy special guests.
IFFGD and DHA grassroots advocates continue to conduct
outreach to Members of Congress in support of a Legislative IFFGD continues to provide support for a children’s FGIMD
Agenda that stresses increasing the federal commitment to research initiative, and peer-reviewed research awards. Through
FGIMDs research and improving patient care. Since the 112th the Digestive Health Alliance, we are looking forward to securing
Congress convened in January of this year, meaningful progress additional funds and expanding both of these programs.
has been made in the following areas:
• Defending federal funding for the National Institutes of As the flagship event of our continuous effort to advance
Health (NIH) and working to secure a funding increase to scientific understanding of FGIMDs, the 9th International
bring the agency’s overall level of support to $35 billion in Symposium on Functional Gastrointestinal Disorders was held
Fiscal Year 2012. on April 8–10, 2011 at the Pfister Hotel in Milwaukee, WI. The
• Introduction and passage of a bill initially drafted by meeting was once again jointly sponsored by the University
IFFGD to bolster support for critical research activities and of Wisconsin School of Medicine and Public Health, Office of
open new avenues of research support, the Functional Continuing Professional Development, and IFFGD. Participation
Gastrointestinal and Motility Disorders Research in this event continues to grow and reflect a growing interest in
• Including “functional gastrointestinal disorders” on the the field. Given the success of this year’s event, we are already
annual list of conditions deemed eligible for study through looking forward to the next Symposium in 2013, and we hope
the Department of Defense’s Peer-Reviewed Medical you are too!
• Passage of a bipartisan bill to increase financial support
for pediatric research networks through NIH, the Pediatric
Research Consortium Establishment Act (H.R. 1080).
www . theromefoundation . org 15
Please Visit our Rome Foundation Booth #2354 at DDW in Chicago
16 r ome foundation
Randall D. Avram
Kilpatrick Townsend & Stockton, LLP
3737 Glenwood Avenue, Ste. 400
Raleigh, NC 27612
Randall D. Avram
We are pleased to introduce Randall D. Avram as our Carolina, Washington, Sweden, Dubai, Japan and Taipei.
Counsel for the Rome Foundation. In this capacity he
will advise the President and Board on issues relating to Randy concentrates his time in labor and employment law
personnel and Business related issues. and is chairman of the Labor and Employment Department.
Randy has been named Best Lawyer in America(r) and as
Randall D. Avram is a partner in the multinational, Top 100 Lawyers by "North Carolina Magazine."
multipractice law firm of Kilpatrick Townsend & Stockton LLP
(Kilpatrick Townsend). KilpatrickTownsend serves clients Since joining us, Randy has helped us develop an effective
in the areas of intellectual property, business and finance, copyright and licensing Policy and has advised us on
construction and infrastructure, government, litigation business relations relative to our sponsors and personnel.
and labor and employment from 18 offices in California, We are most grateful for his interest in helping us.
Colorado, District of Columbia, Georgia, New York, North
Algorithm Publication and Access
The Rome Foundation Diagnostic Algorithms
for Common Gastrointestinal Symptoms are
now available via the following:
• A CD-ROM of all 15 Algorithms is now
available and will be given out at all
Rome Foundation booths.
• The interactive webpage on the Rome
Foundation website will now contain all
15 Diagnostic Algorithms.
• A Spanish version of the Algorithms
was published in November 2010 in the
Mexican Journal of Gastroenterology.
• For free download as a PDF from our
website and the AJG website, www.
www . theromefoundation . org 17
Rome and AGA Forge Collaboration
Senior Vice President
O ur mutually beneficial educational collaboration with the Rome Foundation continues. To recap, we are
excited to conduct our fifth joint lecture series at DDW to shine a spotlight on the importance of research, clinical
education and physician-patient communications related to functional GI disorders. This year our lecture will take
place on Sunday, May 8, from 10:30am to 12 noon in Room E451A of the Convention Center and will feature Tarique
Perera, MD, assistant professor in clinical psychiatry, and Michael D. Gershon, MD, professor of pathology and cell
biology, to provide a comprehensive overview of The Role of Neurogenesis in the Brain and Gut and its Implications
for Functional GI and Motility Disorders. Both internationally renowned experts teach at Columbia University in New
York. We’ve had stellar turn out for these lectures so I hope you can mark it on your schedule to attend.
We will also continue providing marketing support for two Rome created educational activities—the Rome III book
and the Computer Based Learning Program. I hope you have seen our colorful advertisements in Gastroenterology,
Clinical Gastroenterology and Hepatology and in GI and Hepatology News. We want AGA members to be aware of
and purchase these valuable resources at a nice discount!
A new and exciting joint activity is starting to take shape thanks to some preliminary educational support for Forest
Laboratories, Inc. It is a unique communication skills workshop designed to improve the dialogue between physicians
and patients that have functional GI disorders. In order to launch this workshop, we have asked for additional
educational support from other sources and are awaiting a response. If our industry friends are reading this and
want to learn more, please don’t hesitate to contact me (email@example.com) or Dr. Doug Drossman for further details
and how you can help.
As a member of the Rome Foundation Advisory Board, I have truly enjoyed my friendship with the leaders and the
staff of the Rome Foundation and look forward to continuing to grow our relationship in 2011-12 and beyond.
18 r ome foundation
We are pleased tO prOvide fOr yOu in this and future issues artiCles that have been published
that highlight the rOme Criteria.
1: Hellström PM, Saito YA, Bytzer P, Tack J, Mueller- 8: Czyzewski DI, Lane MM, Weidler EM, Williams AE,
Lissner S, Chang L. Characteristics of Acute Pain Attacks Swank PR, Shulman RJ. The interpretation of Rome III
in Patients With Irritable Bowel Syndrome Meeting Rome criteria and method of assessment affect the irritable
III Criteria. Am J Gastroenterol. 2011 Mar 29. [Epub ahead bowel syndrome classification of children. Aliment
of print] PubMed PMID: 21448146. Pharmacol Ther. 2011 Feb;33(3):403-11. doi: 10.1111/
j.1365-2036.2010.04535.x. Epub 2010 Dec 8. PubMed
2: Van Oudenhove L, Holvoet L, Vandenberghe J, Vos
R, Tack J. Do we have an alternative for the Rome III
gastroduodenal symptom-based subgroups in functional 9: Stanghellini V, Frisoni C. Editorial: Reflux, dyspepsia,
gastroduodenal disorders? A cluster analysis approach. and Rome III (or Rome IV?). Am J Gastroenterol. 2010
Neurogastroenterol Motil. 2011 Mar 30. doi: 10.1111/ Dec;105(12):2632-4. PubMed PMID: 21131930.
j.1365-2982.2011.01703.x. [Epub ahead of print] PubMed
10: Hsu YC, Liou JM, Yang TH, Hsu WL, Lin HJ, Wu HT,
Lin JT, Wang HP, Wu MS. Proton pump inhibitor versus
3: Tam YH, Chan KW, To KF, Cheung ST, Mou JW, Pang prokinetic therapy in patients with functional dyspepsia: is
KK, Wong YS, Sihoe JD, Lee KH. Impact of Pediatric therapeutic response predicted by Rome III subgroups? J
Rome III Criteria of Functional Dyspepsia on the Diagnostic Gastroenterol. 2011 Feb;46(2):183-90. Epub 2010 Oct 19.
Yield of Upper Endoscopy and Predictors for a Positive PubMed PMID: 20957498.
Endoscopic Finding. J Pediatr Gastroenterol Nutr. 2011
Apr;52(4):387-91. PubMed PMID: 21415670.
11: Xiao YL, Peng S, Tao J, Wang AJ, Lin JK, Hu PJ,
Chen MH. Prevalence and symptom pattern of pathologic
4: Savarino E, Marabotto E, Zentilin P, Frazzoni M, Sammito esophageal acid reflux in patients with functional dyspepsia
G, Bonfanti D, Sconfienza L, Assandri L, Gemignani L, based on the Rome III criteria. Am J Gastroenterol. 2010
Malesci A, Savarino V. The added value of impedance-pH Dec;105(12):2626-31. Epub 2010 Sep 7. PubMed PMID:
monitoring to Rome III criteria in distinguishing functional 20823838.
heartburn from non-erosive reflux disease. Dig Liver
Dis. 2011 Mar 2. [Epub ahead of print] PubMed PMID:
21376679. 12: Chogle A, Dhroove G, Sztainberg M, Di Lorenzo C,
Saps M. How reliable are the Rome III criteria for the
assessment of functional gastrointestinal disorders in
5: Abid S, Siddiqui S, Jafri W. Discriminant value of Rome III children? Am J Gastroenterol. 2010 Dec;105(12):2697-
questionnaire in dyspeptic patients. Saudi J Gastroenterol. 701. Epub 2010 Aug 31. PubMed PMID: 20808296.
2011 Mar-Apr;17(2):129-33. PubMed PMID: 21372351.
13: Devanarayana NM, Adhikari C, Pannala W, Rajindrajith
6: Ohara S, Kawano T, Kusano M, Kouzu T. Survey S. Prevalence of functional gastrointestinal diseases
on the prevalence of GERD and FD based on the in a cohort of Sri Lankan adolescents: comparison
Montreal definition and the Rome III criteria among between Rome II and Rome III criteria. J Trop Pediatr.
patients presenting with epigastric symptoms in Japan. J 2011 Feb;57(1):34-9. Epub 2010 Jun 4. PubMed PMID:
Gastroenterol. 2011 Feb 26. [Epub ahead of print] PubMed 20525779.
7: Reisswitz PS, Mazzoleni LE, Sander GB, Francisconi
CF. Portuguese validation of the Rome III diagnostic
questionnaire for functional dyspepsia. Arq Gastroenterol.
2010 Dec;47(4):354-60. PubMed PMID: 21225145.
www . theromefoundation . org 19
abOut the rome Board of directors
The Rome Foundation is an
independent not for profit 501(c) 3
organization that provides support for
activities designed to create scientific
data and educational information to
assist in the diagnosis and treatment
of functional gastrointestinal disorders
(FGIDs). Our mission is to improve
the lives of people with functional GI
Over the last 20 years, the Rome
organization has sought to legitimize
and update our knowledge of the
FGIDs. This has been accomplished
by bringing together scientists and
clinicians from around the world to
classify and critically appraise the
science of gastrointestinal function
and dysfunction. This knowledge From left to right: (Front row): Nicholas Talley, John Kellow, Doug Drossman,
permits clinical scientists to make William Whitehead, Lin Chang; (Back row): Jan Tack, Enrico Corazziari,
recommendations for diagnosis and Fernando Azpiroz, Robin Spiller, William D. Chey
treatment that can be applied in
research and clinical practice.
The Rome Foundation is committed
to the continuous development,
legitimization and preservation of the
field of FGIDs through science-based
activities. We are inclusive and
collaborative, patient-centered, astellas Pharma, inc.
innovative and open to new ideas.
The goals of the Rome Foundation
astraZeneca Pharmaceuticals, lP
• Promote clinical recognition and forest laBoratories, inc.
legitimization of the functional GI
disorders furiex Pharmaceuticals, inc.
• Develop a scientific understanding
of their pathophysiological ironwood Pharmaceuticals, inc.
• Optimize clinical management for
patients with FGIDs
lexicon Pharmaceuticals, inc.
shire-movetis Pharmaceuticals, inc.
Procter & gamBle, co.
Prometheus laBoratories, inc.
salix Pharmaceuticals, inc.
visit us on synergy Pharmaceuticals, inc.
the weB at takeda Pharmaceuticals north america, inc.
www.theromefoundation.org Zeria Pharmaceuticals co., ltd.
r ome foundation